The American Civil Liberties Union filed a sweeping federal lawsuit against the U.S. Conference of Catholic Bishops over its ethical guidelines for Roman Catholic hospitals, arguing the directives were to blame for negligent care of a pregnant woman who went into early labor and whose baby died within hours.

The ACLU alleges the bishops were negligent because their religious directives prevented Tamesha Means from being told that continuing her pregnancy posed grave risks to her health and her child was not likely to survive. She was treated at Mercy Health Muskegon, a Catholic hospital in Michigan.

“It’s not just about one woman,” said Kary Moss, executive director of the Michigan ACLU. “It’s about a nationwide policy created by nonmedical professionals putting patients in harms’ way.”

The lawsuit comes amid a wave of mergers between Catholic and secular hospital systems throughout the United States, raising questions about how much religious identity the hospitals will retain and whether they will provide medical services that conflict with church teaching. Advocates for abortion rights and others fear the mergers will limit access to a full range of medical care for women. About 13 percent of U.S. hospitals are Catholic.

Sister Mary Ann Walsh, a spokeswoman for the bishops’ conference in Washington, said it hadn’t been officially notified of the lawsuit and couldn’t comment until it received the complaint. Neither Mercy Health Muskegon nor its corporate parent, Trinity Health in Livonia, would comment Monday. Earlier this year, Trinity Health and Catholic Health East completed a merger, combining more than 80 nonprofit hospitals across about 21 states.

According to the lawsuit, filed Friday in U.S. District Court in Michigan, Means was 18 weeks pregnant in 2010 when her water broke and she went to the nearest hospital in Muskegon. The ACLU said that over several emergency visits, Means was never told that “the safest treatment option was to induce labor and terminate the pregnancy” because the hospital was following the conference’s ethical directives. She eventually delivered the baby, which died after less than three hours. The ACLU says the pathology report found that Means had infections that can result in infertility and other damage.

Under the conference’s “Ethical and Religious Directives for Catholic Health Care Services,” abortion is barred, along with other procedures that go against Catholic doctrine, such as specific infertility treatments or sterilization. However, each bishop has the authority to interpret the directives within his diocese and it is common to find some variation in how the guidelines are applied among dioceses or according to individual cases.

For example, the directives allow for treatments to cure a grave illness in a pregnant woman even if they result in the death of the child. That issue drew national attention in 2010 with the case of a nun and administrator at a Phoenix hospital who, in her role on the hospital ethics committee, approved an abortion to save the life of a pregnant woman. Phoenix Bishop Thomas Olmsted said the decision meant automatic excommunication for the nun and the hospital could no longer identify itself as Catholic.

Robin Fretwell Wilson, a University of Illinois professor who specializes in family and health law, said a negligence claim would hinge in part on whether the ACLU can establish that the conference has some direct control in this case or in hospitals in general. The bishops have moral authority over local Catholic hospitals but are not involved in the day-to-day business of administration.

“It’s so many layers removed,” Fretwell Wilson said, that she has “a difficult time buying” that the bishops’ conference is legally responsible in this case.

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Associated Press writer John Flesher contributed to this story from Traverse City, Mich.